Webinar Recap – Strategic Implications of CMS’s Proposed ACO Rule

August 27, 2018

On Thursday, August 23, experts from Caravan Health held an informational webinar discussing the new CMS proposed rule about the future of Medicare Shared Savings Program Accountable Care Organizations. Caravan Health Senior Vice President Tim Gronniger and Policy and Compliance Officer LeeAnn Hastings reviewed the provisions of the proposed rule and how it could affect ACOs looking to join the program.

This proposed rule was highly anticipated before publication. Tim mentioned some anxiety around whether CMS would propose that all ACOs must take on downside risk right away and said, “The fact of having the rule out there takes away a big part of the uncertainty.” The key takeaway from the webinar is that both new and continuing ACOs will have reasonable options for ACO participation in 2019 and beyond.

CMS is proposing to allow new ACOs to stay in upside risk only for up to two years at the beginning of the program. Proposed changes to the risk path include replacing Tracks 1, 1+, 2, and 3 with new BASIC and ENHANCED tracks. The agreement terms for these new tracks would run for five years, rather than the current three. The new tracks would begin with upside-only risk, similar to current Track 1, but with a lower shared savings rate. ACOs progress along the glidepath, eventually taking on downside risk with the option to move along more quickly.

LeeAnn described additional proposed policy changes, such as availability of the SNF 3-day stay waiver, additional telehealth flexibility, and the Beneficiary Incentive Program for ACOs taking on two-sided risk.

The webinar covered a bit about regulatory process – this proposed rule will be open for comment until October 16 and will likely not be finalized until sometime early next year. This delayed timeline means that CMS built an additional six months into the process by starting the 2019 plan year July rather than January.

Check out our recent blog post for more thoughts on the proposed rule.

If you missed the presentation, click the link below to watch the recording on-demand.

Caravan Health is pleased to announce our 2018 Population Health Pioneer Award Winners. On behalf of everyone at Caravan Health, we congratulate you on your service to your community and commitment to excellence in health care.